HomeMy WebLinkAbout332411 11/21/18 CITY OF CARMEL, INDIANA VENDOR: 355031
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH AMOUNT: $*******282.00*
CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 332411
CHICAGO IL 60677-7001 CHECK DATE: 11/21/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 540088 235.00 MEDICAL FEES
1091 4340700 540088 47.00 MEDICAL FEES
ACCOUNTS PAYABLE VOUCHER
CITY OF--CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 355031 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Community Occupational Health Services Payee
7169 Solution Center
Chicago, IL 60677-7001 In Sum of$ Purchase Order#
355031 Community Occupational Health Services Terms
$ 282.00 7169 Solution Center Date Due
Chicago, IL 60677-7001
ON ACCOUNT OF APPROPRIATION FOR
108-ESE 1109 Monon Center
PO#ornvoice Description
Dept# INVOICE NO. ACCT#/TITLE AMOUNT Invoice Date Number (or note attached invoices)or bill(s)) PO# Amount
1081-99 540088 4340700 $ 235.00 Board Members 11/2/18 540088 Pre-Employment Drug Testing $ 235.00
1091 540088 4340700 $ 47.00 11/2/18 540088 Pre-Employment Drug Testing $ 47.00
I hereby certify that the attached invoice(s),or
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
$ 282.00 Total $ 282.00
November 14,2018
I hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
Cost distribution ledger classification if IPAW94��
claim paid motor vehicle highway fund Signature _,20—
Accounts
20_Accounts Payable Coordinator Clerk-Treasurer
Title
Community`.:Occupationa Health S'vs
7169 SUM,.n Center
�Chicago,,.IL 6067.7-7001_'`
Phone: 3 f7=621=03441 PER r,R7IFr5
FEIN: 35-1955223
Nov 0 9 '2018
BY:
Invoice
Noy imber.'Q2 20T8r {
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 10/18
1411 E. 116th St.
Carmel, IN 46032-
I'V.0ice# :,5,4008;8
Proc Code Date Description 9--ty Change Recei t Adjust Balance
746404 10/18/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Andrew Bowans Balance Due: 47.00
............... -......................................_................................
746404 10/25/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Mary E Cannon Balance Due: 47.00
746404 10/17/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Hannah G Cunningham Balance Due: 47.00
_._........._....-.....__.................._._....................__.._....._........._.-..._...._.....
746404 10/24/2018 Drug Screen-Non NIDA 5 Panel .1.00 47.00 47.00
Soren Foster Balance Due: 47.00
_..
............................ .. - - _..... -- ... ---.._.
746404 10/22/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Samantha M Hardin Balance Due: 47.00
746404 10/19/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Anna Kogler Balance Due: 47.00
Invoice# 540088 Balance Due: S,21
Please remit payment promptly
Cut and return with payment